| NPI | 1548504319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOUR ABBOUSHI Doctor 770-929-0634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 60991) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 60695) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |